Fan Jun-Yu, Chang Cen, Qin Ying-Ying, Jiang Ting, He Dong-Yi
Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai 200052, China.
Zhongguo Zhong Yao Za Zhi. 2022 Apr;47(8):2211-2227. doi: 10.19540/j.cnki.cjcmm.20220106.501.
To evaluate the efficacy and safety of Chinese patent medicines in the treatment of ankylosing spondylitis(AS) by frequency network Meta-analysis. Randomized controlled trials(RCTs)of Chinese patent medicines for AS were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library databases from the time of database establishment to January 2021. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 12 kinds of Chinese patent medicines in 55 RCTs were included. According to Meta-analysis, in term of the effectiveness, the top three optimal medication regimens were Biqi Capsules, Yishen Juanbi Pills and Yaobitong Capsules combined with western medicine. The top three interventions to reduce the erythrocyte sedimentation rate(ESR)were Yishen Juanbi Pills, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. The top three interventions to reduce the C-reactive protein(CRP)were Biqi Capsules, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. In terms of the safety, top three optimal medication regimens were Total Glucosides of Paeony Capsules, Yishen Juanbi Pills, and Wangbi Tablets combined with western medicine. This network Meta-analysis suggests that Chinese patent medicines combined with conventional western medicine can effectively improve the joint pain symptoms of AS patients and reduce the acute inflammatory indicators, with high safety. However, the literature included in this study is generally of low methodological quality, and the conclusion needs to be verified by high-quality research.
通过频率网络Meta分析评估中成药治疗强直性脊柱炎(AS)的疗效和安全性。从中国知网、万方、维普、中国生物医学文献数据库、PubMed、EMbase和Cochrane图书馆数据库中检索自建库至2021年1月期间关于中成药治疗AS的随机对照试验(RCT)。根据Cochrane偏倚风险标准评估纳入RCT的质量,并使用RevMan 5.3和Stata/MP 15.1进行数据分析。共纳入55项RCT中的12种中成药。Meta分析结果显示,在有效性方面,疗效最佳的前三种用药方案为痹祺胶囊、益肾蠲痹丸和腰痹通胶囊联合西药。降低红细胞沉降率(ESR)效果最佳的前三种干预措施为益肾蠲痹丸、仙灵骨葆胶囊和复方玄驹胶囊联合西药。降低C反应蛋白(CRP)效果最佳的前三种干预措施为痹祺胶囊、仙灵骨葆胶囊和复方玄驹胶囊联合西药。在安全性方面,安全性最佳的前三种用药方案为白芍总苷胶囊、益肾蠲痹丸和尪痹片联合西药。该网络Meta分析表明,中成药联合传统西药可有效改善AS患者的关节疼痛症状,降低急性炎症指标,安全性高。然而,本研究纳入的文献方法学质量普遍较低,结论有待高质量研究验证。